Improving Patient Flow: Analysis of an Initiative to Improve Early Discharge

Area of Science:

• Healthcare Management
• Hospital Operations
• Patient Flow Optimization

Background:

• Discharge delays negatively impact hospital bed availability and patient flow.
• Efficient patient flow is crucial for healthcare system performance.

Purpose of the Study:

• To increase the percentage of early discharges (EDCs) before 11 am.
• To determine if achieving at least 25% EDCs would decrease emergency department (ED) and postanesthesia care unit (PACU) hospital bed wait times.

Main Methods:

• A pre/postintervention retrospective analysis was conducted in a quaternary care academic children's hospital.
• Interventions included improved EDC identification, early rounding, and team incentives, implemented over 10 months using Plan-Do-Check-Act cycles.
• Measurements included calendar month EDC percentage and ED/PACU wait times.

Main Results:

• Early discharges (EDCs) increased from an average of 8.8% to 15.8% postintervention.
• Significant reductions in wait times were observed: ED wait times decreased from a median of 221 to 133 minutes, and PACU wait times decreased from 56 to 36 minutes per patient.
• The increase in EDCs and decrease in wait times were statistically significant (P < .01).

Conclusions:

• A multimodal intervention effectively increased early discharges (EDCs).
• The intervention was associated with significant reductions in both emergency department (ED) and postanesthesia care unit (PACU) bed wait times.
• Optimizing discharge processes can improve hospital patient flow and reduce critical care wait times.